title: Health numeracy: the importance of domain in assessing numeracy.
abstract: Existing research concludes that measures of general numeracy can be used to predict individuals' ability to assess health risks. We posit that the domain in which questions are posed affects the ability to perform mathematical tasks, raising the possibility of a separate construct of "health numeracy" that is distinct from general numeracy. The objective was to determine whether older adults' ability to perform simple math depends on domain.
  
  
  
  Community-based participants completed 4 math questions posed in 3 different domains: a health domain, a financial domain, and a pure math domain. Participants were 962 individuals aged 55 and older, representative of the community-dwelling US population over age 54.
  
  
  
  We found that respondents performed significantly worse when questions were posed in the health domain (54% correct) than in either the pure math domain (66% correct) or the financial domain (63% correct). Our experimental measure of numeracy consisted of only 4 questions, and it is possible that the apparent effect of domain is specific to the mathematical tasks that these questions require.
  
  
  
  These results suggest that health numeracy is strongly related to general numeracy but that the 2 constructs may not be the same. Further research is needed into how different aspects of general numeracy and health numeracy translate into actual medical decisions.
authors.affiliation: Survey Research Center, Institute for Social Research, University of Michigan, Ann Arbor, MI (HL, DRW).|School of Public Health, University of Michigan, Ann Arbor, MI (HL)|Gerald R. Ford School of Public Policy, University of Michigan, Ann Arbor, MI (HL)
authors.forename: Helen
authors.initials: H
authors.lastname: Levy
authors.affiliation: Fuqua School of Business, Sanford School of Public Policy, and School of Medicine, Duke University, Durham, NC (PAU)
authors.forename: Peter A
authors.initials: PA
authors.lastname: Ubel
authors.affiliation: Department of Psychology, Grand Valley State University, Allendale, MI (AJD)
authors.forename: Amanda J
authors.initials: AJ
authors.lastname: Dillard
authors.affiliation: Survey Research Center, Institute for Social Research, University of Michigan, Ann Arbor, MI (HL, DRW).
authors.forename: David R
authors.initials: DR
authors.lastname: Weir
authors.affiliation: VA Ann Arbor Center for Clinical Management Research, Ann Arbor, MI (AF)|Division of General Internal Medicine, University of Michigan, Ann Arbor, MI (AF)|Center for Bioethics and Social Sciences in Medicine, Ann Arbor, MI (AF)
authors.forename: Angela
authors.initials: A
authors.lastname: Fagerlin
mesh_terms: D000368:Aged; D006801:Humans; D008433:Mathematics; D008875:Middle Aged; D020377:Self Efficacy; D011795:Surveys and Questionnaires; D013647:Task Performance and Analysis
keywords: cognition; health literacy; health numeracy